Mario Gutiérrez-Bedmar1,2, Miguel Ángel Martínez-González2,3,4,5, Carlos Muñoz-Bravo1, Miguel Ruiz-Canela2,3,4, Alberto Mariscal1, Jordi Salas-Salvadó2,4,6, Ramón Estruch4,7, Dolores Corella4,8, Fernando Arós2,4,9, Monserrat Fito4,10, José Lapetra4,11, Lluís Serra-Majem2,4,12, Xavier Pintó2,4,13, Ángel Alonso-Gómez2,4,9, Olga Portoles4,8, Miquel Fiol4,14, Mónica Bulló2,4,6, Olga Castañer4,10, Emilio Ros4,15, Enrique Gómez-Gracia1,2. 1. Department of Preventive Medicine and Public Health, University of Málaga. 2. The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII). 3. Department of Preventive Medicine and Public Health, University of Navarra Medical School. 4. CIBER Pathophysiology of Obesity and Nutrition, Carlos III Health Institute. 5. Department of Nutrition, Harvard TH Chan School of Public Health. 6. Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Rovira i Virgili University. 7. Department of Internal Medicine, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS). 8. Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia. 9. Department of Cardiology, University Hospital of Araba. 10. Cardiovascular Risk and Nutrition Unit, Hospital del Mar Institut for Medical Research (IMIM). 11. Department of Family Medicine, Research Unit, Sanitary District Primary Care Sevilla. 12. Department of Clinical Sciences, University of Las Palmas de Gran Canaria. 13. Department of Internal Medicine, Hospital Belvitge. 14. Palma Institute of Health Research (IdISPa), Hospital Son Espases. 15. Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS).
Abstract
BACKGROUND: Epidemiological data on chromium (Cr) exposure and the risk of cardiovascular disease (CVD) are still limited. Toenail Cr level (TCL) provides a time-integrated measure reflecting long-term Cr exposure. We measured TCL to assess the hypothesis that long-term Cr exposure was inversely associated with incident CVD in a population at high risk for CVD.Methods and Results: The associations between TCL and CVD were evaluated in a case-control study nested within the "PREvención con DIeta MEDiterránea" (PREDIMED) trial. We randomly selected 147 of the 288 patients diagnosed with CVD during follow-up and matched them on age and sex to 271 controls. Instrumental neutron activation analysis was used to assess TCL. In-person interviews, medical record reviews, and validated questionnaires were used to assess covariates. The fully adjusted OR for the highest vs. lowest quartile of toenail Cr was 0.54 (95% CI: 0.26-1.14; Ptrend=0.189) for the nested case-control study. On stratification for diabetes mellitus (DM), OR was 1.37 (95% CI: 0.54-3.46; Ptrend=0.364) for the DM group, and 0.25 (95% CI: 0.08-0.80; Ptrend=0.030) for the non-DM group (P for interaction=0.078). CONCLUSIONS: The present findings, although not statistically significant, are consistent with previously reported inverse associations between TCL and CVD. These results, especially for non-DM patients, increase the limited epidemiological knowledge about the possible protective role of Cr against CVD. (Trial registration: www.controlled-trials.com; ISRCTN35739639.).
RCT Entities:
BACKGROUND: Epidemiological data on chromium (Cr) exposure and the risk of cardiovascular disease (CVD) are still limited. Toenail Cr level (TCL) provides a time-integrated measure reflecting long-term Cr exposure. We measured TCL to assess the hypothesis that long-term Cr exposure was inversely associated with incident CVD in a population at high risk for CVD.Methods and Results: The associations between TCL and CVD were evaluated in a case-control study nested within the "PREvención con DIeta MEDiterránea" (PREDIMED) trial. We randomly selected 147 of the 288 patients diagnosed with CVD during follow-up and matched them on age and sex to 271 controls. Instrumental neutron activation analysis was used to assess TCL. In-person interviews, medical record reviews, and validated questionnaires were used to assess covariates. The fully adjusted OR for the highest vs. lowest quartile of toenail Cr was 0.54 (95% CI: 0.26-1.14; Ptrend=0.189) for the nested case-control study. On stratification for diabetes mellitus (DM), OR was 1.37 (95% CI: 0.54-3.46; Ptrend=0.364) for the DM group, and 0.25 (95% CI: 0.08-0.80; Ptrend=0.030) for the non-DM group (P for interaction=0.078). CONCLUSIONS: The present findings, although not statistically significant, are consistent with previously reported inverse associations between TCL and CVD. These results, especially for non-DMpatients, increase the limited epidemiological knowledge about the possible protective role of Cr against CVD. (Trial registration: www.controlled-trials.com; ISRCTN35739639.).
Authors: Aaron J Specht; Aisha S Dickerson; Kale Z Kponee-Shovein; Kpobari W Nkpaa; Marc G Weisskopf Journal: Bull Environ Contam Toxicol Date: 2019-11-14 Impact factor: 2.151